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National Initiative VII
Summative PresentationCohort Four
Megan Newman, MD, FACP
Associate Program Director, Internal Medicine Residency
Baylor Scott & White Health Temple, Texas
Cohort Four – Teaming to Improve Care
• Baylor Scott & White, Temple, TX
• Christiana Care Health Services, Newark, DE
• Guthrie Robert Packer Hospital, Sayre, PA
• Aurora Health Care – Cardiology, Milwaukee, WI
• Aurora Health Care – Internal Medicine, Milwaukee, WI
What did you hope to accomplish?Reinforce lessons from a communication workshop using a targeted educational intervention
Create a unique patient experience and provider experience that improved engagement and satisfaction of providers at work
Created a targeted data sharing approach to improve resident quality metrics-focusing initially on diabetes bundle compliance
Improve transitional care management visit rates using multidisciplinary huddles
Improve performance on the diabetes bundle by holding a workshop on how to use EHR dashboards
Improving colon cancer screening rates by having providers call patients and offering alternatives to traditional colonoscopy
Improve communication and feedback between cardiology fellows and faculty; improve efficiency of the Cath lab
Increase advance directive completion numbers for elderly patients through a standardized workflow
What were you able to accomplish?•Diabetes bundle•Colorectal cancer screening•Depression screening•Fall risk screening•Advanced directive completion
•Transitional care management
Improved Quality Metrics
• Root Cause Analysis leading to 3 PDSA cycles
• Faculty training on feedback techniques
Education
• Baseline data collected• Data collection
strategy formulated
Data Collection
• Explicitly defined and trained on communications
Communication
• Improved workplace satisfaction
• Expectations clearly communicated
Wellness
• Brainstorming interventions
• C-suite buy in
Stakeholders Engaged
• ACGME survey faculty feedback score improved
• Resident quality metrics• Residents and Fellows
engaged in QI
Improved Program Metrics
Knowing what you know now, what might you do differently?
No didactics in a pandemic Smaller project
Standardize some component of the
team
Remain connected while physically
distanced
Encourage the intersection of as many
projects as possible
Offer virtual visits more quickly
Speed up PDSA Cycles/ root cause analyses to
get to the true root cause sooner
Communicate data about clinic panels to
residents more frequently
Establish clear expectations for team participation, focused
feedback
Create incentives for resident participation
Earlier introduction of intervention with more
education
On a scale of 1 to 10 (with “1” meaning nothing and “10” meaning everything) how much of what you set out to do was your team able to accomplish and how were your results the same or different from your expectations.
COVID 19 pandemic
restrictions prevented large
didactic sessions, which was our
main intervention
We were able to come together to agree on areas of opportunity and strategies, but
could not complete project due to pandemic
Made educational
series, standardized workflow, we successfully
“teamed”, but didn’t meet target goal
Identified barriers so we know what to focus on in the
future
Early improvements
were lost due to COVID 19
pandemic related process
disruption
Able to achieve our targeted
goal, but further improvements
were hindered by fewer patient appointments
and staff cutbacks
Culture change takes time, but
real progress was made
Exceeded target, Educating
patients on alternatives and importance of screening and direct calls by
providers worked
National Initiative VII
Summative PresentationCohort Five
Cohort Five Presenter
Michelle Noltimier RN BSN MBADirector for Program Development and Student Clinical Education
Office of Health Professional Education
Cohort Five – Program/EducationOur Lady of the Lake Regional Medical Center, Baton Rouge, LAIncorporating Lessons Learned to Increase Participation and Engagement in Interdisciplinary Huddles within Surgical Units
Aurora Health Care – GME, Milwaukee, WIUsing Crisis Response Mock Drills to Prepare Leaders and Enhance Policies
Aurora Health Care – Radiology, Milwaukee, WIRadiation Exposure, Reduction Techniques, and Standardization of Swallow Study Evaluations
HealthPartners, Minneapolis, MNDesigning a Teaming Framework to Align Training to Patient Care Outcomes
Main Line Health, Bryn Mawr, PANurturing Collaborative Skills in the Clinical Learning Environment
Monmouth Medical Center, Long Branch, NJInterprofessional Teaming to Address Hand Hygiene
Ochsner Health System, New Orleans, LATeaming on Labor and Delivery
What did you hope to accomplish? Themes Training
> Use of Medical Improv to improve teaming
> Interprofessional Conferences to improve teaming efficacy.
> Mock Drills to enhance team response to prevent suicide
Quality> Addressing hand hygiene using IP
teams> IP Rounding to improve patient
safety> Implementation of radiation safety
for team members Communication
> Efficiency and situation awareness of team members by enhancing communication through checklists
jssuni.edu.in
What were you able to accomplish?
Teaming Framework developed for training
Interprofessional education conferences
Enhanced training to promote staff safety
Established work groups and pilots
Debriefing as a way to improve process- use of PDSA
Mock Drills to bring policies to life
Spread of success to other areas/departments
Enhanced engagement of teams
Improved patient outcomes related LOS, experience, harm reduction
Identification of safety issues and need for sustained education and training
forbes.com
Knowing what you know now, what might you do differently?
Equal representation and more diverse team member participation
Empowering others to speak up Scope and focus are important Plan for uncertainty Virtual meetings can assist in participation
of members Advocate for technical resources earlier Plan to scale up Teaming might differ in crisis compared to
routine care
dakotabusinesslending.com
What does your CEO need to know to help keep your work sustainable?
Establishing responsibility for work going forward- roles are clear and sustainable
How the work can be incorporated into existing practices and expanded to new settings
Importance of practices as a part of culture change eg hand hygiene
Investment in resources/technology to enhance communication can facilitate desired outcomes
Employing active methods of learning to gain understanding of complicated and high risk issues
Support and engagement from all levels of leadership and clinical practice are important to sustain the teaming approach
em-views.com